Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $912.01 / $1,905.46 / $2,398.83	Facility		$912.01	$1,905.46	$2,398.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $741.31 / $1,479.11	Professional		$575.44	$741.31	$1,479.11
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $1,148.15 / $2,290.87 / $2,398.83	Professional	50	$1,148.15	$2,290.87	$2,398.83
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,630.27 / $4,570.88 / $7,079.46	Facility		$2,630.27	$4,570.88	$7,079.46
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $676.08 / $1,174.90 / $2,818.38	Professional		$676.08	$1,174.90	$2,818.38
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $1,000.00 / $1,737.80 / $4,365.16	Professional	50	$1,000.00	$1,737.80	$4,365.16
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,862.09 / $2,187.76 / $3,467.37	Facility		$1,862.09	$2,187.76	$3,467.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $645.65 / $1,584.89 / $2,570.40	Professional		$645.65	$1,584.89	$2,570.40
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $630.96 / $1,047.13 / $3,548.13	Facility		$630.96	$1,047.13	$3,548.13
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $1,230.27 / $1,621.81 / $1,949.84	Professional		$1,230.27	$1,621.81	$1,949.84
DeanCare Facility/Professional Professional Modifier 50 Low / Median / High Price $1,819.70 / $2,398.83 / $2,951.21	Professional	50	$1,819.70	$2,398.83	$2,951.21
DeanCare Facility/Professional Professional Modifier 54 Low / Median / High Price $977.24 / $1,288.25 / $1,548.82	Professional	54	$977.24	$1,288.25	$1,548.82
DeanCare Facility/Professional Professional Modifier 55 Low / Median / High Price $245.47 / $323.59 / $389.05	Professional	55	$245.47	$323.59	$389.05
Medica Facility/Professional Facility Modifier Low / Median / High Price $630.96 / $1,096.48 / $5,248.07	Facility		$630.96	$1,096.48	$5,248.07
Medica Facility/Professional Professional Modifier Low / Median / High Price $707.95 / $1,513.56 / $5,128.61	Professional		$707.95	$1,513.56	$5,128.61
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $891.25	Professional		$32.36	$33.11	$891.25
Quartz Facility/Professional Professional Modifier Low / Median / High Price $831.76 / $1,584.89 / $2,290.87	Professional		$831.76	$1,584.89	$2,290.87
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,905.46 / $4,073.80 / $4,073.80	Facility		$1,905.46	$4,073.80	$4,073.80
Quartz Facility/Professional Facility Modifier 54 Low / Median / High Price $1,348.96 / $2,884.03 / $2,884.03	Facility	54	$1,348.96	$2,884.03	$2,884.03
Quartz Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $2,511.89 / $5,011.87	Professional		$630.96	$2,511.89	$5,011.87
Security Health Facility/Professional Facility Modifier Low / Median / High Price $1,621.81 / $1,621.81 / $1,621.81	Facility		$1,621.81	$1,621.81	$1,621.81
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,691.53 / $5,888.44 / $6,760.83	Professional		$2,691.53	$5,888.44	$6,760.83
United Facility/Professional Facility Modifier Low / Median / High Price $2,884.03 / $3,630.78 / $6,456.54	Facility		$2,884.03	$3,630.78	$6,456.54
United Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $1,071.52 / $2,754.23	Professional		$588.84	$1,071.52	$2,754.23